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HealthPartners

Coverage criteria policies

Walkers – Minnesota Health Care Programs

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

Prior authorization is not required for walkers.

Coverage

Walkers are generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

Walkers

Walkers are covered for members who are unable to safely ambulate in one or more locations they routinely access due to a temporary or permanent medical condition.

  1. The walker is not required to be needed in the home. Walkers are also covered for members who are able to safely ambulate in the home, but who require a walker for safety in the community.
  2. A walker is covered for members who primarily use wheelchairs, but who require a walker in specific situations,
  3. A heavy-duty walker is covered if a member’s weight, body size or stability makes a standard walker unsafe.
  4. Reverse walkers are considered medically necessary for members who cannot safely use a standard walker.
  5. Only walkers with trunk support are covered for MHCP members in ICFs/DD [Intermediate Care Facility for Persons with Developmental Disabilities].
Gait Trainers

Gait trainers are covered for members who require moderate to maximum support to walk, and who require the equipment to establish or maintain functional gait.

  1. Gait trainers may be covered for members in nursing facilities or ICFs/DD [Intermediate Care Facility for Persons with Developmental Disabilities].

Indications that are not covered

  1. Walkers are not covered for MHCP members in nursing facilities.
  2. Grab bars / wall rails
  3. Portable or installed ramps
  4. White canes for the blind

Definitions

An Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) is a residential facility that is licensed as a health care institution and certified by the Minnesota Department of Health (MDH), and provides health or rehabilitative services for people who require active treatment for developmental disabilities.

If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

The services associated with these codes DO NOT require prior authorization and are covered:

Walkers

HCPCS Codes

Description

E0130

Walker, rigid (pickup), adjustable or fixed height

E0135

Walker, folding (pickup), adjustable or fixed height

E0140

Walker, with trunk support, adjustable or fixed height, any type

E0141

Walker, rigid, wheeled, adjustable or fixed height

E0143

Walker, folding, wheeled, adjustable or fixed height

E0144

Walker, enclosed, 4 sided framed, rigid or folding, wheeled with posterior seat

E0147

Walker, heavy-duty, multiple braking system, variable wheel resistance

E0148

Walker, heavy-duty, without wheels, rigid or folding, any type, each

E0149

Walker, heavy-duty, wheeled, rigid or folding, any type

E0154

Platform attachment, walker, each

E0155

Wheel attachment, rigid pick-up walker, per pair

E0156

Seat attachment, walker

E0157

Crutch attachment, walker, each

E0158

Leg extensions for walker, per set of 4

E0159

Brake attachment for wheeled walker, replacement, each

Gait Trainers

HCPCS Codes

Description

E8000

Gait trainer, pediatric size, posterior support, includes all accessories and components

E8001

Gait trainer, pediatric size, upright support, includes all accessories and components

E8002

Gait trainer, pediatric size, anterior support, includes all accessories and components

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

Vendor

For in-network benefits to apply, items must be received from a contracted vendor.

References

  1. Minnesota Health Care Programs (MHCP) Provider Manual: Equipment and Supplies: Ambulatory Assist Equipment (Revised 01-18-2013)
  2. Minnesota Health Care Programs (MHCP) Provider Manual: ICF/DD (Revised 05-12-2016)

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Policy activity

  • 03/20/2007 - Date of origin
  • 02/01/2017 - Effective date
Review date
  • 01/2017
Revision date
  • 01/19/2017

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